Childhood Disorders

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Mental86
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223348
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Childhood Disorders
Updated:
2013-06-12 00:39:32
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Psych 168
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  1. Disorder according to the APA
    • A behavioral or psychological syndrome or pattern that occurs in an individual
    • Reflects an underlying psychobiological dysfunction (new to DSM-5)
    • Consequences are clinically significant distress or disability
    • Must not be expectable response to common stressors or losses or a cultural standard
    • Not primarily result of social deviance or conflicts with society
  2. What is the most important factor in childhood psychological disorders?
    Age is the most important
  3. Indicators of disorders
    • Time course
    • Quantitative indicators (high/low freq; high/low intensity)
    • Qualitative indicators (inappropriate to situation; beh qualitatively different from normal)
  4. Age of onset Birth to 6 years of age
    • Language Disorders
    • Austism Spectrum Disorder
    • Rett's Disorder
  5. Age of onset 6 to 12 years of age
    • ADHD
    • CD
    • Specific Learning Disorders
  6. Age of onset 12 to 18 years of age
    • SZ
    • Drug Abuse
    • Bulimia Nervosa
    • Anorexia Nervosa
  7. Higher prevalence for boys
    • IDD
    • Language
    • Learning
    • ASD
    • CD
    • Rumination
    • Encopresis
    • Enuresis
    • Tourette's
    • Substance Abuse
    • ADHD
  8. Higher prevalence for girls
    • Rett's
    • Anxiety
    • Depression (later in life, early its equal)
    • Eating
  9. Equifinality
    Different pathways, same disorder
  10. Multifinality
    Similar pathways, different disorders
  11. Multideterminism
    Disorders have many causes
  12. Psychoanalytic Theory
    • Id (Child)
    • Ego (Arbiter)
    • Superego (Rule-maker)
  13. Axon
    Send impulse
  14. Dendrite
    Receive impulse
  15. Midbrain
    Motor supply to muscles
  16. Pons
    Face sensation & movement
  17. Medulla
    • Breathing
    • Heartbeat
    • Digestion
  18. Cerebellum
    Controls motor coordination
  19. Thalamus
    Relay station for sensory input
  20. Hypothalamus
    Regulates behavior & emotion
  21. Limbic System
    • Regulates: Emotional experiences, expressions, basic drives
    • Critical for learning and impulse control
  22. Basal Ganglia
    • Regulates, organizes, filters info related to cognition, emotions, mood, & motor function
    • Highly connected to frontal lobes
  23. GABA
    • Inhibitory NT
    • Moderates emotional response, anger, hostility, aggression
    • Linked to anxiety and discomfort
    • Implicated in Anxiety Disorders
  24. Dopamine
    Involved in exploratory, extroverted and pleasure-seeking behavior

    Implicated: SZ, Mood, ADHD, Substance Abuse
  25. Norepinephrine
    • Controls emergency reactions & alarm responses
    • Role in regulating emotions & behavior
    • Acts to modulate behavioral tendencies (OCD, etc.)
  26. Serotonin
    • Information processing
    • Motor coordination
    • Inhibits tendency to explore
    • Regulates eating, sleeping, aggression
  27. Experiments
    Test cause and effect
  28. Within-Subjects
    Different conditions applied to each subject
  29. Between-subjects
    Different conditions applied to different subjects
  30. Ranking of rates
    Lifetime prevalence > Prevalence rates > Incidence rates
  31. Incidence Rates
    Number of new cases of a disorder in a specific period
  32. Prevalence Rates
    All cases observed at a specific point in time
  33. Lifetime Prevalence
    Number or proportion of cases of a disorder diagnosed at any time in life
  34. Structural Imaging
    • CT
    • MRI
  35. Functional Imaging
    • EEG
    • PET
    • fMRI
  36. Confirmation Bias
    Viewing possible normal behaviors as from a disorder due to a label
  37. ADHD - Inattentive Presentation (Restricted)
    • 6 + Inattentive
    • No more than 2 Hyper-Impulsive
  38. ADHD - Predominantly Inattentive Presentation
    • 6 + Inattentive
    • 3-5 Hyper-Impulsive
  39. ADHD - Predominantly Hyper-Impulsive
    6 of 9 Hyper-Impulsive
  40. ADHD - Combined Presentation
    6 + of both
  41. ADHD - Criteria
    • Symptoms present before 12
    • Present for 6 months
    • Must occur in 2 settings
    • Maladaptive
    • Symptoms not from another disorder
  42. ADHD - Causes
    • Genetics (highly heritable)
    • Neurobiology (Frontal lobe; NTs dopamine and norepinephrine)
    • Birth complications (LBW; injury at birth; small body size; prenatal smoking and alcohol)
    • Psychosocial
  43. Destructive-Covert
    • Property Violations
    • -Setting fires
    • -Stealing
    • -Vandalism
    • -Lying
  44. Destructive-Overt
    • Aggression
    • -Assault
    • -Blaming
    • -Fighting
    • -Bullying
    • -Cruelty
  45. Nondestructive-Covert
    • Status Violations
    • -Abusing substances
    • -Running Away
    • -Swearing
    • -Breaking rules
  46. Nondestructive-Overt
    • Oppositional Behavior
    • -Annoying
    • -Defiant
    • -Arguing
    • -Stubbornness
    • -Anger
    • -Touchiness
  47. ODD
    • Lasting 6 months
    • 4 symptoms with at least one non-sibling
    • -Angry/Irritable Mood
    • -Argumentative/Defiant
    • -Vindictiveness
    • (No physical violence)
  48. CD
    • 3 symptoms in past 12 months, 1 at least in past 6 months
    • -Aggressive to people and animals
    • -Destruction of property
    • -Deceitfulness or theft
    • -Serious violation of rules
  49. CD-additional specifier
    • Significant Callous-Unemotional Traits
    • -2 or more in past 12 months in at least 2 different settings/relationships
    • -Lack of remorse or guilt
    • -Callous-lack of empathy
    • -Unconcerned about performance
    • -Shallow or deficient affect
  50. ASPD
    • Impairments in Self-functioning
    • -Ego-centrism or Self-direction goal-setting
    • Impairments in interpersonal functioning
    • -Lack of empathy or intimacy
    • Antagonism
    • -Manipulativeness, decietfulness, callousness, hostility
    • Disinhibition
    • -Impulsivity, risk-taking
    • Stable across time
    • Not normative, nor substance related
    • At least 18
  51. Substance Use Disorder
    2 or more symptoms within a 12-month period
  52. Splinter Ability
    One that is relatively normal
  53. Savant Ability
    Especially high ability compared to norms
  54. ASD
    • Persistent deficits in social communication, interaction
    • -Social-emotional reciprocity
    • -Nonverbal communication
    • -Developing and maintaining relationships
    • Restricted, repetitive patterns/interests (2 of them)
    • -Speech, motor movements, use of objects
    • -Excessive routines/patterns resistant to change
    • -Fixated interests
    • -Hypo/Hyper-reactivity to sensory input
    • Present in childhood
    • Limit everyday functioning
  55. IDD - Deficit Areas of Adaptive Functioning
    Conceptual, Social, Practical
  56. Fragile-X
    • Pinched X chromosome
    • Large forehead, prominent jaw, low protruding ears, macroorchidism
    • Hypervigilant/sensitive
    • Quantitative/Visuospatial deficits
  57. Williams
    • Deletion of material from chromosome 7
    • Elfin appearance
    • Local over global
    • Dampened amygdala activity
    • Cocktail party syndrome, poetic language, musical prowess
  58. Prader-Willi
    • 7 genes on chromosome 15 missing
    • Short stature, low muscle tone, urge to eat
  59. Angelman
    • 7 genes on chromosome 15 missing
    • Large jaw, open mouthed expression, stiff walk
    • Profound desire for interaction, happy disposition
    • Fascinated with water
  60. Lesch Nyhan
    • Deficiency in HPRT
    • Self-mutilating
    • Hypotonia, chorea
    • Some evidence of a lessened sensitivity to pain
    • Sandy diapers
  61. FAS
    • Smooth Brain, microcephaly
    • Smooth filtrum, thin vermillion, short palpebral fissures
  62. Semantics
    The meaning of words
  63. Pragmatics
    The use of language in context
  64. Speech Sound Disorder
    • Problems with phonology (making the correct sounds)
    • Sound omissions are worse than sound substitutions
  65. Language Disorder
    • Problems with morphology, semantics, or syntax
    • (e.g. use of color-ers instead of crayons)
    • Also related to problems with reading
  66. Social (Pragmatic) Communication Disorder
    • Problems with pragmatics (cannot use language in social contexts)
    • Must rule out ASD
    • New DSM-5 diagnosis
  67. COS SZ
    • Onset younger than 13
    • Two or more symptoms (at least one must be delusions, hallucinations, or disorganized speech) present for 6 months
  68. Major Depressive Episode
    • 5+ in same 2-week period
    • Depressed most of day (kids could be irritable)
    • Anhedonia
    • Weight loss
    • Sleep issues
    • Psychomotor agitation/retardation
    • Fatigue
    • Worthlessness
    • Diminished think or concentrate
    • Thoughts of death
  69. Major Depressive Disorder
    • Single (1 MDE) or Recurrent (2+ MDE)- Presence of MDE, no manic or hypomanic
    • To be considered separate must be interval of 2 consecutive months
  70. Dysthymic Disorder
    • Depressed mood most of day for at least 1 year (adults - 2 years)
    • 2+ of
    • poor appetite/overeating
    • Sleep problems
    • Low energy or fatigue
    • Low self-esteem
    • Poor concentration/decision making
    • Hopelessness
  71. Depressive Disorders - Neurobiological Influences
    • Decreased frontal lobe volume
    • Increase limbic system activity
    • Reduced hippocampus volume
    • Disturbances in HPA
    • Low Serotonin, Dopamine, Norepinephrine
  72. Bipolar Type I
    Mania (psychosis or clinically significant distress) for at least 1 week
  73. Bipolar Type II
    Hypomania (at least 4 days) + MDE
  74. Cylcothymia
    Hypomanic symptoms, depressive symptoms (no MDE, no hypomanic episode; 1 year)
  75. MDD w/ Mixed Features
    MDE + 3 non-overlapping hypomania or mania for 2 weeks
  76. Bipolar Type I w/ Mixed Features
    Mania + 3 non-overlapping features of depression (1 week)
  77. Bipolar Type II w/ Mixed Features
    Hypomania + 3 non-overlapping features of depression (4 days)
  78. Disruptive Mood Dysregulation Disorder
    • 3 or more temper outbursts per week w/ verbal or physical aggression out of proportion
    • Persistently irritable
    • Present for 12 or more months (without 3 or more consecutive months of no symptoms)
    • Two settings
    • Not before age 6 or after 18
    • Onset of symptoms before 10
    • Not during MDD, not with ODD or BD --> if ODD features only DMDD diagnosed
  79. Bulimia Nervosa
    • Rigid, "all or nothing," black and white attitude
    • Overeating and purging
  80. Anorexia Nervosa - Restricted
    Highly controlled, rigid with obsessive tendencies (no b & P)
  81. Anorexia Nervosa - B & P
    Impulsive behaviors, self-injury and substance misuse, more negative outcomes (last 3 months)
  82. Binge Eating Disorder
    • At least once a week for 3 months
    • No compensatory behavior
    • Marked distress from binge eating
    • Associated with low Ghrelin
  83. Body weight issue
    Significantly underweight is a criterion for AN, NOT BN or BED
  84. Bingeing
    All could be except AN - Restricted
  85. Compensatory Behavior
    No CB in BED. Only present in BN & AN - B & P

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